Borejsza-Wysocki Maciej, Bobkiewicz Adam, Francuzik Wojciech, Krokowicz Lukasz, Walczak Dominik, Szmeja Jacek, Banasiewicz Tomasz
Department of General, Endocrinological and Gastroenterological Oncology Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Department of Dermatology, Venerology and Allergology Charité - Universitätsmedizin, Berlin, Germany.
Wideochir Inne Tech Maloinwazyjne. 2021 Dec;16(4):686-696. doi: 10.5114/wiitm.2021.106426. Epub 2021 May 25.
The stoma reversal (SR) procedure is associated with a relatively high risk of perioperative complications with surgical site infection (SSI) as the most common. Recently closed incision negative pressure wound therapy (ciNPWT) was applied widely to prevent SSI.
To investigate the efficiency of ciNPWT in terms of the incidence rate of SSI after SR surgery.
As an exploratory observational cohort study patients were treated either with ciNPWT (n = 15) or standard sterile dressing (SSD) (n = 15). CiNPWT was applied every 3 days whereas SSD was changed every day. Clinical evaluation for SSI signs, C-reactive protein level and pain assessment using the visual analogue scale (VAS) were analyzed.
The incidence rate of SSI was in 13% (2/15) in the ciNPWT group and 26% (4/15) in the SSD group (p = 0.651, OR = 0.44, 95% CI: 0.03-3.73). All patients in the SSD group who developed SSI presented both local and generalized signs of infection. Pain-VAS levels assessed on the 1 (MdnciNPWT = 4, MdnSSD = 5, p = 0.027, W = 51.5) and 3 postoperative day (MdnciNPWT = 2, MdnSSD = 4, p = 0.014, W = 45.5) were significantly lower in the ciNPWT group than in the SSD group.
CiNPWT seems not to have a benefit to reduce SSI after the SR procedure. Further investigation is needed to establish firmly the benefit of using ciNPWT in this group of patients.
造口回纳术（SR）围手术期并发症风险相对较高，手术部位感染（SSI）最为常见。近来，封闭式切口负压伤口治疗（ciNPWT）被广泛应用于预防SSI。
探讨ciNPWT对SR手术后SSI发生率的影响。
作为一项探索性观察队列研究，患者分别接受ciNPWT治疗（n = 15）或标准无菌敷料（SSD）治疗（n = 15）。ciNPWT每3天更换一次，而SSD每天更换。分析SSI体征的临床评估、C反应蛋白水平以及使用视觉模拟量表（VAS）进行的疼痛评估。
ciNPWT组SSI发生率为13%（2/15），SSD组为26%（4/15）（p = 0.651，OR = 0.44，95%CI：0.03 - 3.73）。SSD组所有发生SSI的患者均出现局部和全身感染体征。在术后第1天（MdnciNPWT = 4，MdnSSD = 5，p = 0.027，W = 51.5）和第3天（MdnciNPWT = 2，MdnSSD = 4，p = 0.014，W = 45.5）评估的疼痛VAS水平，ciNPWT组显著低于SSD组。
ciNPWT似乎对降低SR术后SSI无益处。需要进一步研究以明确在这类患者中使用ciNPWT的益处。
